Use of des-aspartate-angiotensin i in inflammation-related pathologies and diseases

ABSTRACT

The present disclosure generally relates to the use of des-aspartate-angiotensin I and/or its derivatives in medicine. In particular, the present invention relates to the use of des-aspartate-angiotensin I and/or its derivatives for the treatment and/or prophylaxis of inflammatory diseases or pathologies, for inducing anti-inflammatory actions and/or reducing inflammation, and/or for treatment of inflammation-related conditions.

FIELD OF INVENTION

The present invention relates to the treatment of pathologies and diseases that are inflammatory in nature. The treatment is practiced by the administration of des-aspartate-angiotensin I or its derivatives to a subject in need of such a treatment. The present invention further contemplates the use of des-aspartate-angiotensin I or its derivatives in the treatment and/or prophylaxis of cellular inflammation arising from chemical, physical, and biological insults. The use of this invention excludes the inflammatory pathologies associated with the following diseases: cardiac hypetrophy, neointima formation, restenosis, arteriosclerosis, glomerulosclerosis and renal failure, infarction-related cardiac injuries and disorders, diabetes, and viral infection.

BACKGROUND OF THE INVENTION

Des-aspartate-angiotensin I is an endogenous angiotensin peptide (Sim and Qiu, Regul. Pept., 111:179-182 (2002)). It is formed from angiotensin I by a specific aminopeptidase present in blood vessels and the hypothalamus (Sim, Biochem. Pharmacol., 45:1524-1527 (1994); Sim et al., Biochem. Pharmacol., 48:1043-1046)). Our previous studies have shown that des-aspartate-angiotensin I exerts useful cardiovascular and renal actions (U.S. Pat. Nos. 5,773,415; 6,100,237; US2003/0086920 A1; U.S. Pat. No. 6,589,938 B2) attenuates insulin resistance in type 2 diabetic animals and combats viral infection (Sim et al., Endocrinology, 148:5925-5932 (2008); PCT No. WO 2007/030082 A1). Earlier studies have also shown that des-aspartate-angiotensin I acts as an agonist on the angiotensin AT1 receptor and that its actions were indomethacin sensitive (Sim and Soh, Eur. J. Pharmacol., 284:215-219 (1995); Sim and Chai, Br. J. Pharmacol., 117:1504-1506 (1996); Min et al., Regul Pept., 95:93-97 (2000); Wen et al., Regul Pept., 120:149-153 (2004)). The present invention identifies a specific interaction between des-aspartate-angiotensin I and the angiotensin AT1 receptor in which only prostaglandins E2 and I2 (PGE2 and PGI2) are produced by the enzymatic action of COX1. PGE2 and PGI2, so produced, mediate the biological actions of des-aspartate-angiotensin I. PGE2 acts on its receptor, which exists as four subtypes (EP1 to EP4). It produces a variety of responses which blur the line between it being categorized as a proinflammatory or anti-inflammatory molecule, (Fraser, Int. Rev. Immunol., 27:320-350 (2008)). PGE2 and PGI2 are involved in inflammation-related vasodilation and synergize with other proinflammatory mediators to increase vascular permeability and promote edema (Khanapure et al., Curr. Top. Med. Chem., 7:311-340 (2007)). Current understanding of the roles of COX1 and COX 2 in physiology, pathophysiology and inflammation are also equivocal and there are conditions where either COXs could be involved in inflammation (Rouzer and Marnett, J. Lipid Res., 50:S29-S34 (2009)). In the context of the dual pro- and anti-inflammatory roles of PGE2 and PGI2, and COX1 and COX2, this invention shows a specific novel pathway in which des-aspartate-angiotensin I acts on the angiotensin AT1 receptor and activates only COX1 to produce PGE2 and PGI2. In the setting of diseases and pathologies that are inflammatory in nature, it was surprisingly discovered that the PGE2 and PGI2 so produced attenuate the symptoms of the diseases and pathologies.

Inflammation is a complex response to injurious stimuli and is mediated and influenced by pleiotropic cytokines. Hence, an earlier study by Rufaihah et al. wrongly concluded that the cardioprotective effect of des-aspartate-angiotensin I was due to its suppression of genes of pro-inflammatory cytokines IL-6, TGF-β and GM-CSF that were upregulated in the rat model of myocardial infarction (Rufaihah et al., Life Sci., 78:1341-1351 (2006)). Firstly, the cytokines IL-6, TGF-β and GM-CSF have been shown to exhibit anti-inflammatory properties. IL-6 is an anti-inflammatory cytokine and attenuates the production of TNF-α in inflammation (Ulich et al., Am. J. Pathol., 138:1097-1101 (1991); Denis, J. Leuko. Biol., 52:197-201 (1992)). This probably accounted for the absence of des-aspartate-angiotensin I effect on upregulated TNF-α gene in the first 7 days of Rufaihah's study. TGF-β is a potent anti-inflammatory cytokine; surviving mice with knockout TGF-β gene exhibit fulminating inflammatory lesions of the heart and other organs (Kulkarni and Karlsson, Am. J. Pathol., 143:3-9 (1993)). In addition, high level of TGF-β in cow milk has been shown to protect against inflammation in mice (Ozawa et al., J. Nutr., 139:69-75 (2009)). GM-CSF is highly pleiotropic and has been shown to exhibit anti-inflammatory actions in inflammatory gut diseases (Korzenik et al., N. Engl. J. Med., 352:2193-2201 (2005); Sainathan et al., Inflamm. Bowel Dis. 14:88-99 (2008)). Secondly, cytokine gene profile in the contralateral area of normal heart tissues was also affected by des-aspartate-angiotensin I especially TNF-α gene, which increased in level in des-aspartate-angiotensin I treated animals in Day 3. Thirdly, an increase in cytokine gene expression does not necessarily translate to protein expression of the cytokine. Therefore, Rufaihah's study does not teach that the actions of des-aspartate-angiotensin I are anti-inflammatory in the rat model of myocardial infarction. It, however, teaches that des-aspartate-angiotensin I exerts cardioprotective effects, which resulted in the gradual normalization of upregulated gene expression of IL-6, TGF-β, and CM-CSF.

The ability of des-aspartate-angiotensin I to combat diseases bearing different pathologies and in different organs is not only unique but intriguing. While researching the mechanisms of its multi-disease action, it was surprisingly found that DAA-I specifically halts the early events of inflammation. These anti-inflammatory actions were useful in inflammatory diseases arising from chemical, physical, and biological insults and/or causes.

SUMMARY OF THE INVENTION

The present invention addresses the problems above and provides new uses and/or method(s) for des-aspartate-angiotensin I and its derivatives. In particular, des-aspartate-angiotensin I and its derivatives are used for the treatment and/or prevention of inflammatory diseases and their symptoms. The treatment and/or prevention consist(s) of administering to a subject or human patient, in need of such treatment or prevention, an effective amount of des-aspartate-angiotensin I or its derivatives for a time and under conditions sufficient for the onset of inflammatory symptoms to be prevented, inhibited or delayed or the symptoms of the inflammation to be ameliorated. The inflammatory diseases include (but are not restricted to):

-   -   (1) diseases resulting from exposure to a vesicant or toxic         chemical that causes systemic and/or localized inflammation;     -   (2) skeletal muscle damage that resulted from unaccustomed or         excessive strenuous use or exercise;     -   (3) heat stroke that resulted from exposure to high ambient         temperature or strenuous exercise;     -   (4) Parkinson's disease or degenerative brain conditions         resulting from inflammation;     -   (5) diseases that are caused by over-expressed proinflammatory         cytokines such as, but no restricted to, TNF-α;     -   (6) diseases that are caused by over-production of ROS such as,         but not restricted, H₂O₂;     -   (7) diseases that are caused by LPS or gram negative bacteria         that produce LPS;     -   (8) malignant and invasive growth, tumor, tumor metastasis or         cancer;     -   (9) inflammatory diseases that are ameliorated or cured by the         agonistic action of des-aspartate-angiotensin I and/or its         derivative on the angiotensin AT1 receptor in which PGE2 and         PGI2 are produced by COX1.

Another aspect of the present invention provides a composition for use in the treatment and/or prevention of inflammatory diseases and their symptoms in a subject in need of such treatment and/or prevention comprising administering to the patient an effective amount of des-aspartate-angiotensin I or its derivatives.

In yet another aspect, the present invention provides a method or composition for use in the treatment and/or prevention of inflammatory diseases and their symptoms in a subject in need of such treatment and/or prevention comprising administering to the patient an effective amount of des-aspartate-angiotensin I or its derivatives and at least one pharmaceutically acceptable carrier, excipient, diluent and/or adjuvant.

There is also provided a kit comprising des-aspartate-angiotensin I or its derivatives, wherein the kit is for the treatment and/or prevention of inflammatory diseases and their symptoms.

Des-aspartate-angiotensin I, its derivatives or the pharmaceutical composition according to the invention may be administered in solid or liquid form.

Further, des-aspartate-angiotensin I, its derivatives or the pharmaceutical composition may be administered in conjunction with at least one pharmaceutical agent. The at least one pharmaceutical agent is an angiotensin converting enzyme inhibitor, an angiotensin receptor antagonist, and/or at least one type of stem cell.

BRIEF DESCRIPTION OF THE DRAWINGS

The present invention will be readily understood by the following detailed description in conjunction with the accompanying drawings. In some of the drawings (FIGS. 1-19), des-aspartate-angiotensin I was abbreviated as DAA-I, and half sulfur mustard as HSM.

FIG. 1 shows that HSM damaged lung alveoli in mice. Damaged type 1 alveolar cells released T1α protein, which was quantitated by Western blotting (upper panel). DAA-I, given at a dose of 75 nmole/kg/day, significantly attenuated the release of T1α protein and complete attenuation was seen at 14 day of treatment (lower panel).

FIG. 2 shows that HSM caused an increase in superoxide production in the lung of mice, which was quantitated colormetically (upper panel). Excessive superoxide cause significant damage to cell structures. DAA-I treatment (75 nmole/kg/day) significantly attenuated the production of superoxide from day 4 to end of treatment at day 14 (lower panel).

FIG. 3 shows that HSM caused an increase in ICAM-1 production in the lung of mice, which was quantitated by Western blotting (upper panel). ICAM-1 is produced by injured lung endothelial cells. It recruits leucocytes to site of injury resulting in inflammation. DAA-I treatment (75 nmole/kg/day) significantly attenuated the production of ICAM-1 from day 4 to end of treatment at day 14 (lower panel).

FIG. 4 shows that HSM caused an increase in MPO level in the lung of mice. MPO is a specific enzyme of neutrophils. Increased level of MPO in the lung indicates increased neutrophil infiltration and inflammation. DAA-I treatment (75 nmole/kg/day) significantly attenuated the level of lung MPO and in this way attenuated the inflammation caused by HSM.

FIG. 5 shows that HSM caused an increase in gp91-phox protein in the lung of mice, which was quantitated by Western blotting (upper panel). gp91-phox protein is an integral component of NADPH oxidase, the enzyme that generated superoxide. DAA-I treatment (75 nmole/kg/day) significantly attenuated the increase in lung gp81-phox protein (lower panel).

FIG. 6 shows that HSM caused a temporal increase in PGE2 (upper panel) and a decrease in PGI2 (lower panel) in the lung of mice. DAA-I treatment (75 nmole/kg/day) significantly enhanced the increase in PGE2 and attenuated the decrease in PGI2. These findings show that PGE2 and PGI2 are involved in the action of DAA-I. (Ng et al., J. Appl. Toxicol. (Epub ahead of print, 9 Nov. 2010)).

FIG. 7 shows that the protective action of DAA-I against HSM intoxication was blocked by losartan, an angiotensin AT1 receptor blocker. At a dose of 0.5 nmole/kg, losartan by itself had no effect on the survival of HSM-intoxicated mice. However, this dose when given together with DAA-I completely blocked the protective action of DAA-I showing the angiotensin AT1 receptor mediate the protective action of DAA-I.

FIG. 8 shows that at a dose of 10⁻¹⁰ M, DAA-I specifically induced the production of PGE2 (upper panel) and PGI2 (lower panel) in HUVEC. At a higher concentration of 10⁻⁵ M, DAA-I was less effective and mimicked the action of angiotensin II.

FIG. 9 shows that at a dose of 10⁻¹⁰ M, DAA-I had no effect on the basal production of PGF2α (upper panel) and thromboxane A2 (lower panel) in HUVEC. At a higher concentration of 10⁻⁵ M, DAA-I mimicked angiotensin II in inducing the production of PGF2α and TXA2.

FIG. 10 shows that the ability of DAA-I to induce production of PGE2 and PGI2 in HUVEC was blocked by losartan and indomethacin, and not by PD123319 and NS 398. Losartan is an angiotensin AT1 receptor blocker and PD123319 is an angiotensin AT2 receptor blocker. Indomethacin is an inhibitor of both COX1 and COX2, and NS 398 is a specific inhibitor of COX2. Thus, the results show that DAA-I acted on the angiotensin AT1 receptor and stimulated COX1 leading to the production of PGE2 and PGI2.

FIG. 11 shows that H₂O₂ induced L6 skeletal muscle cells to overexpress ICAM-1, which was quantitated by flow cytometry (upper panel). At the maximum effective dose of 200 μM, the overexpression was 8 times the basal level (lower panel).

FIG. 12 shows that DAA-I attenuated the H₂O₂-induced overexpression of ICAM-1 in L6 skeletal muscle cells, which was quantitated by flow cytometry (upper panel). At the maximum effective dose of 10⁻¹⁰ M, the attenuation was 100% (lower panel).

FIG. 13 shows that DAA-I attenuated that the H₂O₂-induced translocation of NF-κB into the nucleus of L6 skeletal muscle cells, which was quantitated by Western blotting (upper panel). At the maximum effective dose of 10⁻¹⁰ M, the attenuation was over 90% (lower panel).

FIG. 14 shows that heat stoke increased production of hepatic heat shock proteins 27 and 70 in mice, which was quantitated by Western blotting (upper panel). Pretreatment of mice with 7.5 nmole/kg DAA-I significantly enhanced the production (lower panel). At this dose, DAA-I also protected mice from dying from heat stroke (see Table 1). The results show that DAA-I protected mice from heat stroke by enhancing the increase production of heat stoke proteins 27 and 70.

FIG. 15 shows that dopamine concentration-dependently caused death of SH-SY5Y neuroblastoma cells (upper panel). DAA-I concentration-dependently protected cell death induced by 400 μM dopamine (lower panel). At a concentration of 10⁻¹² M, DAA-I accorded the maximum protection (over 90%).

FIG. 16 shows that high glucose caused death of pancreatic beta-TC-6 cells (upper panel). DAA-I concentration-dependently protected cell death induced by 33.3 mM glucose (lower panel). At a concentration of 10⁻¹² M, DAA-I accorded the maximum protection (over 90%).

FIG. 17 shows that LPS increased production of superoxide production in A549 cells (upper panel). DAA-I concentration-dependently inhibited the production (lower panel). At a concentration of 10⁻¹² M, the inhibition was complete.

FIG. 18 shows that LPS increased production of E-selectin in A549 cells (upper panel). DAA-I concentration-dependently inhibited the production (lower panel). At a concentration of 10⁻¹² M, the inhibition was complete.

FIG. 19 shows that DAA-I concentration-dependently inhibited viability of cultured B16-F10 melanoma cells (upper panel), and production of heat shock protein 90 in the same cells (lower histograms). The maximum effect occurred at 10⁻¹⁰ M DAA-I.

DETAILED DESCRIPTION OF THE INVENTION

Definition of Derivatives of Des-Aspartate-Angiotensin I

First Definition: Derivatives of des-aspartate-angiotensin I are defined as peptides containing nine or less aminoacids in which arginine and histidine constitute the first and fifth aminoacid, respectively, of each sequence or only arginine is present as the original first aminoacid, and only histidine is present as the original fifth aminoacid of each sequence. This definition was based on an earlier study showing that the critical aminoacids of des-aspartate-angiotensin I that are responsible for its activity are arginine and histidine placed in position of 1 and 5 of the peptide sequence, respectively (Chen et al., Regul. Pept., 106:39-46 (2002)) and that angiotensin IV, a secondary metabolite of des-aspartate-angiotensin I that lacks arginine as the first aminoacid is also effective in combating cardiac hypertrophy and restenosis (PCT No. WO 2006/078223 A1).

Second Definition: Derivatives of des-aspartate-angiotensin I are also defined as peptide fragments that are its metabolites. These include peptide fragments such as, but not restricted to, Tyr-Ile-His-Pro-Phe, De-His-Pro-Phe, Val-Tyr. These three peptides have been shown to exert hypoglycemic action in C57BL/6J mice (see Example 10).

EXAMPLE 1

Source of Materials

Des-aspartate-angiotensin I was purchased from Peptisyntha (Belgium). Tyr-Be-His-Pro-Phe, Ile-His-Pro-Phe, and Val-Tyr were purchased from Bachem (Switzerland). Des-aspartate-angiotensin I and the three angiotensin fragments can be prepared by techniques well known in the art. 2-chloroethyl ethyl sulfide (known as half sulfur mustard) was purchased from Sigma-Aldrich (St. Louis, Mo.). Virus and cell lines were purchased from ATCC (Manassas, Va.). All antibodies were purchased from Santa Cruz Biotechnology (Santa Cruz, Calif.). Prostaglandin assay kits were purchased from Cayman Chemical Company (Ann Arbor, Mich.). HUVEC was purchased from VEC Technologies (Rensselaer, N.Y.). Balb/c and C57/BL/6J mice were obtained from the Animal Center, National University of Singapore.

EXAMPLE 2

Development of a Mouse Model of Lung Inflammation with Half Sulfur Mustard

Half sulfur mustard is a vesicant, and when inoculated into the lungs of mice causes intense lung inflammation and death. By adjusting the lethal dose of the half sulfur mustard, animals could be made to survive and serve as model of lung inflammation for the study of the anti-inflammation actions of des-aspartate-angiotensin I. The protocols to be described in Examples 3 to 7 are part of a research project that studied counter measures and antidotes against vesicant compounds that could be used as chemical weapons by terrorists. Since the filing of the present patent, the protocols and the findings of this research have been accepted for publication (Ng et al., J. Appl. Toxicol. (Epub ahead of print, 9 Nov. 2010)).

Nine to 10 weeks old Balb/c mice were randomly allotted into 5 groups of 7 mice. The mice were anaesthetized with avertin and intranasally inoculated with various doses of half sulfur mustard dissolved in 25 μL 50% ethanol. Animals in the control group were inoculated with vehicle. The survival of the mice was monitored for 21 days. Half sulfur mustard dose-dependently increased the mortality of the animals. The study was repeated. The dose of 0.28 mg/kg in which 65% of the animals had died by Day 21 (LD65) was used to study the anti-inflammatory action of des-aspartate-angiotensin I.

EXAMPLE 3

Monitoring and Treatment (with Orally-Administered Des-Aspartate-Angiotensin I) of Half Sulfur Mustard-Inoculated Balb/c Mice

Mice were randomly allotted into 6 groups of 10 mice. The animals were intranasally inoculated with LD65 half sulfur mustard as described above. The animals were then orally administered (by gavage) various dose of des-aspartate-angiotensin I in 0.1 ml water daily for 14 days. Animals in the control group were administered vehicle. The survival of the mice was monitored for 21 days. The study was repeated twice. Des-aspartate-angiotensin I dose-dependently attenuated the mortality of half sulfur mustard-inoculated mice. The dose of 75 nmole/kg exerted maximum attenuation. At this dose 20 out of 30 mice survived as compared with 10 out of 30 mice in the control group. This dose was used in subsequent studies on the anti-inflammatory actions of des-aspartate-angiotensin I in pulmonary tissues of half sulfur mustard-inoculated mice. The protocols of water or des-aspartate-angiotensin I administration (treatment) were also adopted (in Examples 4-7).

EXAMPLE 4

Effect of Orally-Administered Des-Aspartate-Angiotensin I on the Presence of T1α Protein in Bronchoalveolar Lavage Fluid (BALF) of Mice Inoculated with Half Sulfur Mustard

Type 1 alveolar cells produce T1α protein (which is specific to the cells). The damaging effects of half sulfur mustard on the alveoli could be measured by assaying the level of T1α protein in BALF. BALF is obtained by flashing the lungs of anaesthetized mice with 0.5 ml of buffered saline. The results of the study are summarized in FIG. 1, which shows that des-aspartate-angiotensin I significantly attenuated the level of T1α protein in BALF of mice inoculated with half sulfur mustard, confirming that des-aspartate-angiotensin I blocks the damaging actions of half sulfur mustard.

EXAMPLE 5

Effect of Orally-Administered Des-Aspartate-Angiotensin I on the Overproduction of Superoxide, Intercellular Adhesion Molecule-1 (ICAM-1), and Infiltration of Neutrophil in Lungs of Mice Inoculated with Half Sulfur Mustard

At site of cellular damage, pro-inflammatory mediators, e.g. superoxide and cytokines, are released from damaged or injured cells. These inflammatory mediators induced formation of adhesion molecules, e.g. ICAM-1 and selectins, which attract leucocytes, e.g. neutrophils and macrophages, to the site of cellular damage. The leucocytes extravasate and produce cytokines of their own and initiate the process of inflammation. FIGS. 2-4 show that des-aspartate-angiotensin I attenuated these three early processes of inflammation, i.e. the increase in pulmonary production of superoxide and ICAM-1, and infiltration of neutrophils into the lung of mice. The infiltration of neutrophils was measured by assaying myloperoxidase (MPO), a specific enzyme produced by neutrophils. The source of superoxide is NADPH oxidase (Bedard and Krause, Physiol. Rev., 87:245-313 (2008)), and FIG. 5 shows that des-aspartate-angiotensin I attenuates the upregulated NADPH oxidase.

EXAMPLE 6

Involvement of PGE2 and PGI2 in the Anti-Inflammatory Actions of Des-Aspartate-Angiotensin I (in Lungs of Mice Inoculated with Half Sulfur Mustard)

FIG. 6 shows the involvement of PGE2 and PGI2 in the anti-inflammatory actions of des-aspartate-angiotensin I in the half sulfur mustard inoculated mouse lung. Half sulfur mustard induced an elevation of pulmonary PGE2 in the period between 7 and 14 days post exposure. Des-aspartate-angiotensin I treatment exaggerated the onset and magnitude of this elevation. Significant increase of the prostaglandin was observed on Day 1, and peak level on Day 7 post exposure. PGI2, measured as its stable metabolite 6-keto PGF1α, showed an opposite trend. Its concentration decreased following HSM exposure and maximum decrease occurred at Day 7 post exposure. Des-aspartate-angiotensin I treatment attenuated the decreasing trend, and a marked increase in the prostaglandin was seen at Day 14 post exposure.

EXAMPLE 7

Des-Aspartate-Angiotensin I Exerts its Anti-Inflammation Actions via the Angiotensin AT1 Receptor (in Mice Inoculated with Half Sulfur Mustard)

The angiotensin AT1 receptor is characterized by its susceptibility to blockade by losartan (de Gasparo et al., Pharmacol. Rev., 52:415-472 (2000)). Hence, biological responses mediated by the angiotensin AT1 receptor are blocked by losartan. To show that the actions of des-aspartate-angiotensin I are mediated by the angiotensin AT1 receptor, its anti-mortality (which is the resultant of its anti-inflammation actions) was subjected to blockade by losartan. FIG. 7 shows that losartan completely attenuated the anti-mortality action of des-aspartate-angiotensin I confirming that the nonapeptide acts on the angiotensin AT1 receptor.

EXAMPLE 8

Des-Aspartate-Angiotensin I Specifically Releases PGE2 and PGI2 via its Action on the Angiotensin AT1 Receptor

The endothelium is intimately involved in inflammation (Pober and Sessa, Nat. Rev. Immunol., 7:803-815 (2007)), and human umbilical vein endothelial cells (HUVEC) are extensively used to study its role in inflammation (Boyle et al., Circulation 98:(19 Suppl):II282-II288 (1998); Ferrante et al., Cir. Res., 99:34-41 (2006)). FIG. 8 shows that des-aspartate-angiotensin I specifically releases PGE2 and PGI2 from HUVEC at the sub nanomolar concentration of 10⁻¹⁰ M. At 100,000 times this concentration (10⁻⁵ M), its actions become non specific and mimic those produced by 10⁻⁷ M angiotensin II. FIG. 9 shows des-aspartate-angiotensin I had no effect on the production of PGF2α and thromboxane A2. In similar studies carried out with a concentration range of 10⁻¹² to 10⁻⁵ M, des-aspartate-angiotensin I exerts non specific action at a concentration of 10⁻⁶ M. However in terms of clinical uses, a drug is never administered at concentrations 10,000 times higher than its effective concentration. FIG. 10 shows that the action of des-aspartate-angiotension I is mediated by the angiotensin AT1 receptor, and COX1 is the enzyme involved in the production of PGE2 and PGI2.

EXAMPLE 9

Effect of Orally-Administered Des-Aspartate-Angiotensin I on Other Inflammatory Pathologies and Diseases

The ability of des-aspartate-angiotensin I to exert anti-inflammatory actions in inflammatory pathologies and related disease was studied in the following in vitro and in vivo biological systems:

a. Skeletal Muscle Damage

Unaccustomed and excessive strenuous exercise causes skeletal muscle damage. Both in vivo and in vitro studies indicate that reactive oxygen species (ROS) play a critical role in the damage (Sachdev and Davis, Free Radic. Biol. Med., 44:215-223 (2008); Wataru et al., Free Radic. Biol. Med., 37:480-487 (2004); Sen et al., Biochem. Biophys. Res. Commun., 237:645-649 (1997); Maruhashi et al., J. Physiol. Sci., 57:211-216 (2007); Kerkweg et al., Shock 27:552-558)). Oxidative stress, structural muscle damage, and muscle inflammation (resulting from the exercise) generate excess ROS that overwhelm cellular antioxidant defenses and cause tissue damage. The effect of des-aspartate-angiotensin I in overcoming H₂O₂ (an important ROS)-induced ICAM-1 formation in L6 skeletal muscle cells was studied. FIGS. 11 and 12 show that L6 skeletal muscle cells overexpressed an 8-fold increase in ICAM-1 when incubated with 200 μM H₂O₂, and des-aspartate-angiotensin I concentration-dependently attenuated the H₂O₂-induced overexpression of ICAM-1 with a remarkable 100% attenuation at a concentration of 10⁻¹⁰ M. In muscle damage, ROS like H₂O₂ activates NF-κB and causes its translocation into the nucleus. Following this, NF-κB stimulates the transcription of its target genes resulting in the synthesis of proinflammatory proteins including ICAM-1, which trigger the inflammatory cascade (Wataru et al., Free Radic. Biol. Med., 37:480-487 (2004); Sen et al., Biochem. Biophys. Res. Commun., 237:645-649 (1997)). FIG. 13 shows that, under similar conditions in which des-aspartate-angiotensin I attenuated ICAM-1 overexpression, the activation and translocation of NF-κB to the nucleus was >90% attenuated by 10⁻¹⁰ M des-aspartate-angiotensin I.

b. Heat Stroke

Heat stroke is a life-threatening illness caused by an extreme increase in core body temperature as a result of exposure to high ambient temperature or strenuous exercise. Despite the availability of intensive medical intervention, heat stroke is often fatal and effective therapy is lacking (Bouchama and Knochel, N. Engl. J. Med., 346:1978-1988 (2002)). The reasons could be due to the systemic inflammatory responses to heat stroke, which are in many ways similar to those of sepsis that lead to multi-organ failure. Heat stroke is often fatal and our study was devised to test the effect of DAA-I on the survival of mice exposed to heat stroke. The study was based on the method described by Mota et al. (Crit. Care Med. 36:526-534 (2008)). Ten 8 to 9 weeks old male C57/BL/6J mice were, randomly group into 2 groups of 5 animals. One group was orally administered (by gavage) 7.5 nmole/kg des-aspartate-angiotensin I and the other group (control group) was similarly administered vehicle. Two hours after des-aspartate-angiotensin I administration, the animals were placed in a cage that was preheated to 42° C. in a ventilated oven (Labnet Model 211DS). The animals were continuously exposed to 42° C. for 45 min. The number of animals that survived the first 24 hours following the 45 min heat exposure was recorded. Two such experiments were performed. Table 1 shows that des-aspartate-angiotensin I increased the survival of mice subjected to heat stroke.

TABLE 1 Effect of des-aspartate-angiotensin I on survival of mice subjected to heatstroke Survival (Number out of 5 animals) Dose of Des-aspartate-angiotensin I Female Mice Male Mice 0 (vehicle) 2 1 7.5 nmole/kg 4 4 0 (vehicle) 3 0 7.5 nmole/kg 5 4

FIG. 14 shows that heat stroke increased production of hepatic heat shock protein 27 and 70 in C57BL/6J mice, which is in concordance with similar findings of Mota et al. (Crit. Care Med. 36:526-534 (2008)). Des-aspartate-angiotensin enhanced the production of heat shock protein 27 and 70, and the enhancement is a likely mechanism of its protective actions action. The dose of 7.5 nmole/kg was determined to be an effective dose in preliminary dose-response experiments.

c. ICAM-1 Production in HUVEC

Pro-inflammatory cytokines increase ICAM-1 expression in a variety of cells, and this occurs in the early stages of inflammation (Hubbard and Rothlein, Free Radic. Biol. Med., 28:1379-1386 (2000)). TNF-α is a major pro-inflammatory cytokine and has been used to stimulate ICAM-1 production in HUVEC for study of anti-inflammatory agents (Zhou et al., Eur. J. Pharmacol., 513:1-8 (2005); Gutierrez et al., Atherosclerosis 190:90-99 (2007)). Similar protocols were used to study the anti-inflammatory actions of des-aspartate-angiotensin I. HUVEC were exposed to 4 ng/ml TNF-α and various concentrations of des-aspartate-angiotensin I for 6 hours. The cells from each sample were then washed and treated with anti-ICAM-1 antibody and further incubated with FITC-conjugated secondary antibody. ICAM-1 level in each sample was determined by flow cytometry as described in FIG. 12. Table 2 shows that des-aspartate-angiotensin I attenuated the TNF-α-induced upregulation of ICAM-1 production in HUVEC. Maximum attenuation occurred at a concentration of 10⁻¹⁰ M.

TABLE 2 Effect of des-aspartate-angiotensin I on TNF-a-induced production of ICAM-1 in HUVEC Doses of drugs % of Fluorescence Vehicle (PBS)   3 ± 0.13 4 ng/ml TNF-α ^(#)12 ± 1.6 4 ng/ml TNF-α + 10⁻⁸ M des-aspartate angiotensin I ^(#)*6 ± 1.1 4 ng/ml TNF-α + 10⁻¹⁰ M des-aspartate angiotensin I   *3 ± 0.35 4 ng/ml TNF-α + 10⁻¹² M des-aspartate angiotensin I ^(  #)*5 ± 0.43 ^(#)Significantly different from the vehicle value *Significantly different from the 4 ng/ml TNF-α value

d. Dopamine-Induced Neuroblastoma SH-SY5Y Cell Death

Enhanced oxidative stress has been implicated in the genesis of Parkinson's disease, and dopamine is a major cause of the oxidative stress (Hasting et al., Proc. Natl. Acad. Sci. USA., 93:1956-1961 (1996); Barzilai and Shirvan, Cell Mol. Neurobiol., 21:215-235 (2001); Miyazaki and Asunuma, Acta Med Okayama 62:141-150 (2008)). Human neuroblastoma SH-SY5Y cell is a dopaminergic neuronal cell line that has been used as an in vitro model for the study of Parkinson's disease (Gomez-Santos et al., J. Neurosci. Res. 73:341-350 (2003); Jiang et al., Hum Mol Genet 13:1745-1754 (2004); Jiang et al., Synapse 62:797-802 (2008)). High concentrations of dopamine induce death in SH-SY5Y cells mimicking the death of nigral dopaminergic neurons caused by excessive exogenously administered or endogenously produced dopamine (Barzilai and Shirvan, Cell Mol. Neurobiol., 21:215-235 (2001); Miyazaki and Asunuma, Acta Med Okayama 62:141-150 (2008); Gomez-Santos et al., J. Neurosci. Res. 73:341-350 (2003)). This model of dopamine-induced cell death in SH-SY5Y cells was used to study the anti-inflammation actions of des-aspartate-angiotensin I. FIG. 15 shows that des-aspartate-angiotensin I significantly attenuated the death of SH-SY5Y cells caused by high concentration of dopamine. Maximum attenuation occurred at a concentration range of 10⁻¹⁰ to 10⁻¹² M des-aspartate-angiotensin I.

e. Glucose-Induced Pancreatic Beta-TC-6 Cell Death

High glucose concentration induces formation of ROS, which damage and kill cells including pancreatic β cells (Nishikawa et al., Nature 404:787-790 (2006); Du et al., Free Radic. Biol. Med., 35:1491-1499 (2003); Robertson and Harmon, Free Radic. Biol. Med. 41:177-184 (2006)). Pancreatic beta TC-6 cells, an insulin-secreting cell line, which are responsive to glucose and glucagon-like peptide-1 (Poitout et al., Diabetes Metab. 22:7-14 (1996); Masur et al., Mol. Endocrinol. 19:1373-1382 (2005)) were used to study the protective action of des-aspartate-angiotensin. FIG. 16 shows that des-aspartate-angiotensin I significantly attenuated the death of pancreatic beta TC-6 cells cause by high concentration of glucose. Maximum attenuation occurred at a concentration of 10⁻¹² M.

f. LPS-Induced Superoxide and E-Selection Production in A549 Human Lung Epithelial Cells

As described in Example 5, superoxide is one of the earlier mediators of inflammation that promote the formation of adhesion molecules (see also the skeletal muscle damage study described above) and infiltration of leucocytes. In this study, LPS, the toxic and inflammatory cellular product of pathogenic gram negative bacteria, was used as an inflammatory stimulus. As several gram negative bacteria (Hemophilus influenzae, Klebsiella pneumoniae, Legionella pneumophila, Pseudomonas aeruginosa) specifically infect the human lung, a human lung epithelial cell line, A549, was used. Unlike HUVEC, which was susceptible to the auto-produced superoxide in response to LPS (Simon and Fernandez, J Hypertens 27:1202-1216 (2009)) the superoxide produced by A549 cells had no effect on itself. FIG. 17 shows that LPS concentration-dependently induced the production of superoxide in A549 cell and DAA-I concentration-dependently attenuated the production of superoxide induced by the maximum effective concentration of LPS. The LPS-induced expression of E-selection in A549 cells was also concentration-dependently attenuated by DAA-I (FIG. 18). In both experiments, the maximum effective concentration DAA-I had no effect on the basal level of superoxide or E-selectin.

g. Cancer

That inflammation plays a role in the development of cancer has long been appreciated (Balkwill and Mantovani, Lancet 357:539-645 (2001); Lu et al., Mol. Cancer Res., 4:221-233 (2006); Borello et al., Cancer Lett., 267:262-270 (2009)), and recent studies show a relationship between inflammation and tumor metastasis (Wu and Thou, Cell Cycle 8:3267-3273 (2009)). In the present study, the effect of des-aspartate-angiotensin I on the development and metastasis of B16-F10 melanoma cells in C57BL/6J mice was investigated. This protocol is an adaptation of the method described by Ren et al. (Stem Cell 26:2332-2338 (2008)) where melanoma cells grow and metastasize in the fully immunocompetent C57BL/6J mouse. The melanoma cells were cultured in DMEM containing 100 U/ml penicillin, 100 μg/ml streptomycin, and 10% fetal calf serum in a 25 cm² flask. Upon confluence, the cells were dislodged with trypsinized PBS, quenched with DMEM and centrifuged (250 g for 8 minutes). The cells were finally re-suspended in PBS and counted and prepared as solution containing 250 cells in 10 μl PBS for administration to mice. Each mouse was anaesthetized with avertin and its abdomen surgically opened up to expose the liver. Melanoma cell preparation was intra-hepatically administered (into the largest lobe) and the abdomen was stitched up using surgical thread. Following this, animals were orally administered 150 nmole/kg/day des-aspartate-angiotensin I for 19 days. Control animals were similarly administered vehicle (water). Animals were killed on the 20^(th) day and their abdomens opened up to expose the liver. The administered melanoma cells developed in the liver as colonies of various sizes. It was also noted that metastatic melanoma cells occurred in abdominal lymphatic system of some animals. Table 3 shows that des-aspartate-angiotensin I attenuated the growth of melanoma cells in liver and abdominal lymphatics of mice, and seven out of ten animals were without tumor growth in the des-aspartate-angiotensin I treated group as compared to four out of ten animals in the control group.

TABLE 3 Effect of des-aspartate-angiotensin I on growth of intra-hepatic administered melanoma cells in mice No. of mice with tumor growth in liver and abdominal No. of mice with no tumor Treatment n liver lymphatics growth Des- 10 4 2 6 aspartate- angiotensin I Vehicle 10 6 5 4 (water)

An in vitro study was carried out to investigate the effects of DAA-1 on cell growth and heat shock protein 90 (Hsp90) expression in melanoma cells. B16-F10 melanoma cells were grown to confluence in 25 cm² flask. The cells were rinsed, trypsinised and seeded into 6-well plates at a density of 8×10⁴ cells per well. The cells were grown overnight in 10% serum medium, and attained about 80% confluence. The growth medium was changed to one that contained 2% serum, followed by addition of various doses of DAA-1 (10⁻⁶ M to 10⁻²⁰ M). The cells were incubated for 24 hours, after which cells were used either for cell viability assay or Hsp90 determination. Cell viability was assayed by staining with 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT; Sigma-Aldrich, St. Louis, Mo.). Briefly, the cells were incubated with 0.5 mg/ml MTT for approximately 1 h at 37° C. in the dark. The medium was aspirated and formazan products formed in viable cells were solubilised with 100 μl dimethylsulfoxide. Viability was quantified by spectrophotometry at 570 nm absorbance using a 96-well plate reader. Hsp90 was determined by Western blotting. Briefly, cells were subjected to lysis buffer (50 mM HEPES/NaOH (pH 7.5), 150 mM NaCl, 2 mM EDTA, 10% glycerol, 10 mM NaF, 2 mM Na₄VO₄, 1 mM phenylmethylsulfonylfluoride and 10 mM Na₄P₂O₇) for 1 h at 4° C. The protein concentration of the lysate was quantified and 20 μg of protein lysate were then resolved through SDS-PAGE, and probed with Hsp 90 and actin antibodies for western blot analysis. Goat-anti-Hsp90 (1:400 dilution) and mouse-anti-actin (1:4000 dilution) primary antibodies were used. Anti-goat-HRP conjugated (1:20000 dilution) and anti-mouse-HRP conjugated (1:20000 dilution) secondary antibodies were used, respectively. Autoradiography was carried using CL-XPosure film (Thermo Scientific, IL), with exposure time of 15 s to 10 min. The average band intensity was quantified by optical density using Bio-Rad Quantity 1 software. FIG. 19 shows that DAA-I attenuated the growth of melanoma cells at concentrations of 10⁻¹⁰ to 10⁻¹⁴ M. The cellular content of Hsp90 was similarly attenuated at these concentrations of the peptide. The in vitro data indicate that des-aspartate-angiotensin I exerts its anti-cancer action by attenuating the production of Hsp90 in melanoma cells. Hsp90 has recently been shown to promote melanoma cell growth and Hsp90 antibodies or inhibitors block cell motility and invasion in vitro and metastasis in vivo (Tsutsumi and Neckers, Cancer Sce. 98:1536-1539 (2007)).

EXAMPLE 10

Hypoglycemic Action of Tyr-Ile-His-Pro-Phe, Ile-His-Pro-Phe, Val-Tyr

The C57BL/6J mice are sensitive to metabolic manipulation (Prarekh et al. Metabolism 47:1089-1096 (1998); Opara et al., J. Nutr., 126:273-279 (1996); Collins et al., Physiol. Behav. 81:243-248 (2004)), and des-aspartate-angiotensin I was surprisingly found to exert hypoglycemic action in this euglycemic animals (Sim et al., Endocrinology 148:5925-5932 (2008)). This euglycemic animal model was used to test the hypoglycemic action of three metabolites of des-aspartate-angiotensin I, namely: Tyr-Ile-His-Pro-Phe, Ile-His-Pro-Phe, and Val-Tyr. Table 4 shows that the three metabolites exerted significant hypoglycemic action in this euglycemic animal.

TABLE 4 Hypoglycemic action of metabolites of des-aspartate-angiotensin I Serum Glucose Concentration (mM) at 30 min Metabolite of Oral Glucose Tolerance Test 0 (vehicle)  17.45 ± 0.78 Tyr-Ile-His-Pro-Phe (400 nmole/kg) *12.4 ± 0.8 Ile-His-Pro-Phe (400 nmole/kg)  *13.0 ± 0.72 Val-Tyr (400 nmole/kg) *11.39 ± 1.12 Animals were orally administered (by gavage) 200 nmole/kg/day for 14 days. Oral glucose tolerance was performed after an overnight fast. *Significantly different from vehicle value

While this invention has been particularly shown and described with references to example embodiments thereof, it will be understood by those skilled in the art that various chances in form and details may be made therein without departing from the scope of the invention encompassed by the appended claims. Furthermore, certain terminology has been used for the purposes of descriptive clarity, and not to limit the present invention. The embodiments and preferred features described above should be considered exemplary, with the invention being defined by the appended claims. 

1. A method for the treatment and/or prevention of inflammatory diseases and pathologies or diseases that are inflammatory in nature in a subject in need of such treatment and/or prevention comprising administering to the subject an effective amount of des-aspartate-angiotensin I or its derivatives.
 2. The method according to claim 1, wherein at least one of the inflammatory diseases or pathologies is a result of exposure to a vesicant or toxic chemical that causes systemic and/or localized inflammation.
 3. The method according to claim 1, wherein at least one of the inflammatory diseases or pathologies is skeletal muscle damage that results from unaccustomed or excessive strenuous use or exercise.
 4. The method according to claim 1, wherein at least one of the inflammatory diseases or pathologies is heat stroke that results from exposure to high ambient temperature or strenuous exercise.
 5. The method according to claim 1, wherein at least one of the inflammatory diseases or pathologies is Parkinson's disease or a degenerative brain condition resulting from inflammation.
 6. The method according to claim 1, wherein the inflammatory diseases or pathologies are mediated by over-expressed proinflammatory cytokines such as TNF-α.
 7. The method according to claim 1, wherein the inflammatory diseases or pathologies are mediated by over-produced ROS such as H₂O₂.
 8. The method according to claim 1, wherein the inflammatory diseases or pathologies are mediated by LPS or gram negative bacteria that produce LPS.
 9. The method according to claim 1, wherein at least one of the inflammatory diseases or pathologies is a malignant and invasive growth, tumor, tumor metastasis or cancer.
 10. The method according to claim 1, wherein the inflammatory diseases or pathologies are ameliorated or cured by the agonistic action of des-aspartate-angiotensin I and/or its derivative on the angiotensin AT1 receptor in which PGE2 and PGI2 are produced by COX1.
 11. The method according to claim 1, wherein des-aspartate-angiotensin I or its derivative is administered in a pharmaceutically and/or therapeutically effective amount.
 12. The method according to claim 1, wherein the des-aspartate-angiotensin I or its derivative is administered in combination with at least one pharmaceutically-acceptable carrier, excipient, diluent and/or adjuvant.
 13. The method according to claim 1, wherein the des-aspartate-angiotensin I or its derivative is administered by a therapeutically effective route of administration.
 14. The method according to claim 1, wherein des-aspartate-angiotensin I or its derivative/s is administered in solid or liquid form.
 15. The method according to claim 1, wherein des-aspartate-angiotensin I or its derivatives is administered in conjunction with at least one pharmaceutical agent.
 16. The method according to claim 15, wherein the at least one pharmaceutical agent is an angiotensin converting enzyme inhibitor.
 17. The method according to claim 15, wherein the at least one pharmaceutical agent is an angiotensin receptor antagonist.
 18. The method according to claim 15, wherein the at least one pharmaceutical agent is a type of stem cell.
 19. A pharmaceutical composition comprising an effective amount of des-aspartate-angiotensin I or its derivatives, and at least one pharmaceutically acceptable carrier, excipient, diluent and/or adjuvant. 20-55. (canceled)
 56. A kit comprising des-aspartate-angiotensin I or its derivatives, wherein the kit is for the treatment and/or prevention of inflammatory diseases and pathologies or diseases that are inflammatory in nature in a subject in need of such treatment and/or prevention. 